VAERS ID: |
902923 (history) |
Form: |
Version 2.0 |
Age: |
34.0 |
Sex: |
Female |
Location: |
Arkansas |
Vaccinated: | 2020-12-16 |
Onset: | 2020-12-17 |
Days after vaccination: | 1 |
Submitted: |
0000-00-00 |
Entered: |
2020-12-17 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
- / UNK |
- / - |
Administered by: Unknown Purchased by: ? Symptoms: Asthenia,
Chills,
Myalgia,
Nausea SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: NAUSEA, CHILLS, MUSCLE PAIN, WEAKNESS |